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青少年早期、中期和晚期的抑郁:认知素质-应激模型的不同证据。

Depression in early, middle and late adolescence: differential evidence for the cognitive diathesis-stress model.

机构信息

Developmental, Personality and Social Psychology, Ghent University, Ghent, Belgium.

出版信息

Clin Psychol Psychother. 2013 Sep-Oct;20(5):369-83. doi: 10.1002/cpp.1789. Epub 2012 Apr 4.

Abstract

UNLABELLED

Cognitive theory is a prominent framework to study depression in both adults and adolescents. This theory stated that dysfunctional schemas are moderators (known as diathesis) in the association of current stress and psychopathology. However, in adolescents, less evidence has been found so far to corroborate the importance of these schemas. This study aimed to investigate in a cross-sectional design the moderating role of adolescents' early maladaptive schemas (EMS) on depressive symptoms. This will be studied in relation to both important daily stressors (i.e., maternal, paternal and peer rejection) and stressful life events.

METHOD

Adolescents (N = 228, age 12-18 years), selected from inpatient and outpatient clinical settings and a non-referred sample, completed questionnaires and interviews measuring psychopathology, cognitive schemas, peer rejection, maternal and paternal rejection, and stressful life events. Parents completed questionnaires about their adolescent measuring psychopathology, stressful life events and peer rejection, as well as their own parental behaviour.

RESULTS

Correlational analyses revealed significant associations between the study variables. Evidence was found for an interaction effect between the adolescents' EMS and peer rejection in explaining depressive symptoms, but only in late adolescents.

KEY PRACTITIONER MESSAGE

Stress induced by maternal and, in lesser extent, paternal rejection is contributing to depressive symptoms primarily in younger and to lesser extent in older age groups. The quality of peer relationships becomes an increasingly salient source of distress as adolescence unfolds and is certainly an important mechanism affecting depression in adolescence. Maladaptive schemas only start functioning as a cognitive diathesis in late adolescence, increasing depression in response to peer-related distress. Since maladaptive schemas are not yet operating as cognitive vulnerability factors in early and middle adolescence, early interventions for depressive disorders may be more effective compared with treatment in later adolescence.

摘要

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认知理论是研究成年人和青少年抑郁的重要框架。该理论指出,功能失调的图式是当前压力和精神病理学之间关联的调节因素(称为素质)。然而,到目前为止,在青少年中,发现的证据较少,无法证实这些图式的重要性。本研究旨在横断设计中调查青少年早期适应不良图式(EMS)对抑郁症状的调节作用。这将研究与重要的日常压力源(即母亲、父亲和同伴拒绝)和生活应激事件有关。

方法

从住院和门诊临床环境以及非转诊样本中选择青少年(N=228,年龄 12-18 岁),完成问卷和访谈,以测量精神病理学、认知图式、同伴拒绝、母亲和父亲拒绝以及生活应激事件。父母完成关于其青少年的问卷,以衡量精神病理学、生活应激事件和同伴拒绝,以及他们自己的父母行为。

结果

相关分析显示研究变量之间存在显著关联。发现青少年 EMS 和同伴拒绝之间的相互作用效应可解释抑郁症状,但仅在晚青春期存在。

主要从业者信息

母亲和(在较小程度上)父亲拒绝引起的压力导致抑郁症状,主要在年轻组中,在年龄较大的组中程度较小。随着青春期的发展,同伴关系的质量成为越来越明显的困扰来源,这肯定是影响青春期抑郁的一个重要机制。适应不良的图式仅在青春期后期开始作为认知素质发挥作用,对与同伴相关的痛苦做出反应,增加抑郁。由于在青春期早期和中期,适应不良的图式尚未作为认知易感性因素起作用,因此与青春期后期治疗相比,早期干预抑郁障碍可能更有效。

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